It is the backward flow of acid from the stomach up into the
esophagus.

What causes heartburn?

The digestive system turns food into energy and removes waste
from the body.

It is made up of the mouth, esophagus (tube to the stomach),
the small and large intestine, and the rectum.

In normal digestion, a muscle called the LES (see figure
below) blocks the esophagus so acid from the stomach can't go back
up into the throat.

Heartburn happens when the muscle doesn't work right and lets
acid from the stomach back up into the throat.

Infants and children can get heartburn if their digestive
system is not working right yet.

Who can get heartburn?

Anyone can get heartburn.

Infants and children can get heartburn.

Heartburn is more common in the elderly and in women during
pregnancy.

Children with developmental or neurological disabilities are
more likely to get heartburn than healthy children. Their symptoms
may be worse.

What are the symptoms of heartburn?

Heartburn is usually felt as a burning chest pain or pressure
in the chest. The pain starts behind the breastbone and moves up
to the neck and throat.

Some people taste the bitter and sour acid that has moved up
their throat from the stomach.

Almost all infants spit up, but if an infant spits up or
throws up almost every time he eats and seems fussy, he may have
heartburn.

Symptoms can last as long as 2 hours.

Symptoms are often made worse by eating food.

Lying down and bending over often makes symptoms worse.

Symptoms of heartburn are often mistaken for signs of a heart
attack or heart disease. Pain from a heart condition is usually
made worse by physical activity. Heartburn is not usually caused
by physical activity.

If you think you are having a heart attack, go to the
emergency room immediately.

How is heartburn treated?

In many cases, symptoms can be controlled by making diet and
lifestyle changes.

Avoid food and drinks that can lead to heartburn such as
chocolate, coffee, peppermint, greasy (fried) or spicy foods,
tomato products, and alcohol.

Try eating smaller portions of food.

Stop smoking.

If overweight, lose weight.

Avoid eating 2-3 hours before bed.

Prop up your head on a higher pillow to sleep.

Use an over-the-counter antacid, such as Maalox or Tums.

Standing up instead of lying down or bending over can often
ease pain.

Your doctor may send your child to a gastroenterologist (a
doctor who specializes in disorders of the gastrointestinal
tract).

The doctor may take tests to find the cause of the
problem.

In few cases, surgery may be needed.

Infants and children with heartburn usually grow out of the
condition.

How long does heartburn last?

Symptoms can last as long as 2 hours.

If left untreated, heartburn can lead to serious problems. It
can cause severe chest pain, make the esophagus narrow, or cause
bleeding.

How can heartburn be prevented?

Avoid food and drinks that can lead to heartburn.

Stop smoking.

Lose weight if needed.

Avoid eating 2-3 hours before bed.

When should I call the doctor?

If symptoms do not improve after making diet and lifestyle
changes, call your doctor.

Call if your child is using over-the-counter medication for
heartburn more than 2 times a week.

Call if your child feels as if food is trapped behind the
breastbone, if he vomits blood or has black stools, if he become
short of breath, coughs, chokes, or is hoarse.

Call your doctor if you have questions or concerns.

Quick Answers

Gastroesophageal reflux disease (GERD) is a digestive disorder
that is also called heartburn and acid indigestion.

Heartburn happens when acid from the stomach goes back up into
the throat.

Anyone can get heartburn, even infants and children. It is
more common in the elderly, pregnant women, and children with
disabilities.

Heartburn is usually felt as a burning chest pain or pressure
in the chest.

Symptoms can usually be controlled by making diet and
lifestyle changes.

Symptoms can last as long as 2 hours. If left untreated,
heartburn can lead to serious problems.

To prevent heartburn, avoid food and drinks that can lead to
heartburn, stop smoking, lose weight if needed, and avoid eating
2-3 hours before bedtime.

If symptoms do not improve after making diet and lifestyle
changes, call your doctor.

References

American College of Gastroenterology. Common GI Problems:
Gastroesophageal Reflux Disease (GERD). (cited 2001 December 4).
Available from: URL:
http://www.acg.gi.org/acg-dev/patientinfo/cgp/cgpvol1.html#gerd

Borowitz SM. Gastroesophageal Reflux in Infants. Children's
Medical Center of the University of Virginia. 1997 (cited 2001
December 04). Available from: URL:
http://www.people.virgina.edu/~smb4v/tutorials/reflux/ger.htm

National Institute of Diabetes and Digestive and Kidney
Diseases. Gastroesophageal Reflux Disease (Hiatal Hernia and
Heartburn). 2000 April (cited 2001 December 04). Available from:
URL:
http://www.niddk.nih.gov/health/digest/pubs/heartbrn/heartbrn.htm

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The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.